Women's Health Department, Yancheng Maternal and Child Health Hospital, Yancheng, Jiangsu, China.
Department of Occupational and Environmental Health, School of Public Health, Anhui Medical University, Meishan Road 81, Hefei, Anhui, China.
Environ Sci Pollut Res Int. 2019 Mar;26(7):6717-6724. doi: 10.1007/s11356-019-04157-7. Epub 2019 Jan 10.
Accumulating evidence has shown that prenatal ambient air pollution exposure is associated with elevated stillbirth risk; however, the results are inconsistent. This population-based prospective cohort study aimed to explore the association between prenatal air pollution exposure and stillbirth rate in the coastal area in China. Data of air pollution and birth outcomes between January 1, 2015, and December 31, 2017, were collected. Among the 59,868 eligible births, there were 587 stillbirths and 59,281 live births. Although the air quality in this study was relatively better than most of the major cities in China, a positive association was still found between prenatal air pollution exposure and stillbirth rate. Every 10 μg/m increase of fine particulate matters (PM) in each trimester, as well as in the entire pregnancy, was associated with increased stillbirth rate (RR = 1.14, 1.11, 1.15, and 1.14 for the first, second, third trimester, and entire pregnancy, respectively). In addition, every 10 μg/m increase of PM in the first trimester (RR = 1.09, 95% CI: 1.04-1.14), and 10 μg/m increase of O in the first (RR = 1.05, 95% CI: 1.01-1.09) and third (RR = 1.04, 95% CI: 1.00-1.08) trimesters was also associated with increased stillbirth rate. The effects of PM on stillbirth rate were found to be robust in the two-pollutant models. The findings of this study especially underscored the adverse effects of prenatal exposure of high levels of PM on stillbirth. More studies are needed to verify our findings and further investigate the underlying mechanisms.
越来越多的证据表明，产前环境空气污染暴露与死胎风险增加有关;然而，结果并不一致。本研究采用基于人群的前瞻性队列研究，旨在探讨中国沿海地区产前空气污染暴露与死胎发生率的关系。收集了 2015 年 1 月 1 日至 2017 年 12 月 31 日期间的空气污染和出生结局数据。在 59868 例合格分娩中，有 587 例死胎和 59281 例活产。尽管本研究中的空气质量相对优于中国大多数主要城市，但仍发现产前空气污染暴露与死胎率之间存在正相关。在每个孕期，每增加 10μg/m 的细颗粒物(PM)，死胎率均升高(第一、二、三孕期和整个孕期的 RR 分别为 1.14、1.11、1.15 和 1.14)。此外，第一孕期 PM 每增加 10μg/m(RR=1.09,95%CI:1.04-1.14)，第一和第三孕期 PM 每增加 10μg/m(RR=1.05,95%CI:1.01-1.09;RR=1.04,95%CI:1.00-1.08)，死胎率也升高。在双污染物模型中，PM 对死胎率的影响是稳健的。本研究的结果特别强调了产前高水平 PM 暴露对死胎的不良影响。需要进一步的研究来验证我们的发现，并进一步探讨其潜在机制。
